The Youth Fitness International Test (YFIT) battery for monitoring and surveillance among children and adolescents: A modified Delphi consensus project with 169 experts from 50 countries and territories

Francisco B Ortega; Kai Zhang; Cristina Cadenas-Sanchez; Mark S Tremblay; Gregor Jurak; Grant R Tomkinson; Jonatan R Ruiz; Katja Keller; Christine Delisle Nyström; Jennifer Sacheck; Russell Pate; Kathryn L Weston; Tetsuhiro Kidokoro; Eric Poon; Lucy-Joy M Wachira; Ronald Ssenyonga; Thayse Natacha Q F Gomes; Carlos Cristi-Montero; Brooklyn J Fraser; Claudia Niessner; Vincent O Onywera; Yang Liu; Li-Lin Liang; Stephanie A Prince; David R Lubans; Justin J Lang; The Delphi Fitness Expert Group

doi:10.1016/j.jshs.2024.101012

The Youth Fitness International Test (YFIT) battery for monitoring and surveillance among children and adolescents: A modified Delphi consensus project with 169 experts from 50 countries and territories

J Sport Health Sci. 2024 Nov 12:101012. doi: 10.1016/j.jshs.2024.101012. Online ahead of print.

Authors

Francisco B Ortega¹, Kai Zhang², Cristina Cadenas-Sanchez³, Mark S Tremblay⁴, Gregor Jurak⁵, Grant R Tomkinson⁶, Jonatan R Ruiz⁷, Katja Keller⁸, Christine Delisle Nyström⁹, Jennifer Sacheck¹⁰, Russell Pate¹¹, Kathryn L Weston¹², Tetsuhiro Kidokoro¹³, Eric Poon¹⁴, Lucy-Joy M Wachira¹⁵, Ronald Ssenyonga¹⁶, Thayse Natacha Q F Gomes¹⁷, Carlos Cristi-Montero¹⁸, Brooklyn J Fraser¹⁹, Claudia Niessner⁸, Vincent O Onywera²⁰, Yang Liu²¹, Li-Lin Liang²², Stephanie A Prince²³, David R Lubans²⁴, Justin J Lang²⁵, The Delphi Fitness Expert Group²⁶

Affiliations

¹ Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada; and CIBEROBN Physiopathology of Obesity and Nutrition; Granada, ES18071, Spain; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FI40014, Finland. Electronic address: ortegaf@ugr.es.
² Healthy Activity Living and Obesity (HALO) research group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1, Canada; School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada.
³ Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada; and CIBEROBN Physiopathology of Obesity and Nutrition; Granada, ES18071, Spain; Department of Cardiology, Stanford University, Stanford, CA, 94305, USA; Veterans Affair Palo Alto Health Care System, Palo Alto, CA, 94304, USA.
⁴ Healthy Activity Living and Obesity (HALO) research group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1, Canada; Department of Pediatrics, University of Ottawa, Ottawa, ON, K1H 8L1, Canada.
⁵ University of Ljubljana, Faculty of Sport, 1000, Ljubljana, Slovenia.
⁶ Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA, 5001, Australia.
⁷ Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada; and CIBEROBN Physiopathology of Obesity and Nutrition; Granada, ES18071, Spain; Instituto de Investigación Biosanitaria, ibs.Granada, Granada, ES18012, Spain.
⁸ Institute for Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, 71631, Germany.
⁹ Department of Medicine Huddinge, Karolinska Institute, 141 83, Huddinge, Sweden.
¹⁰ Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, 20052, USA.
¹¹ Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
¹² Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, G1 1QE, UK.
¹³ Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA, 5001, Australia; Nippon Sport Science University, Faculty of Sport Science, Tokyo, 158-8508, Japan.
¹⁴ Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China.
¹⁵ Department of Physical Education, Exercise and Sports Science, School of Health Sciences, Kenyatta University, P.O Box 43844-00100, Nairobi, Kenya.
¹⁶ Department of Epidemiology and Biostatistics, College of Health Sciences, Makerere University, P. O Box 7072, Kampala, Uganda.
¹⁷ Department of Physical Education, Federal University of Sergipe, São Cristóvão, 49107-230, Brazil; Department of Physical Education and Sport Sciences, Health Research Institute, Physical Activity for Health Research cluster, University of Limerick, Limerick, V94 T9PX, Ireland.
¹⁸ IRyS group, Physical Education School, Pontificia Universidad Católica de Valparaiso, Valparaiso, 2374631, Chile.
¹⁹ Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA, 5001, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, 7000, Australia.
²⁰ KCA University, Division of Research, Innovation and Outreach, P. O. Box 56808 - 00200, Nairobi, Kenya.
²¹ School of Physical Education, Shanghai University of Sport, Shanghai, 200438, China.
²² Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University.
²³ Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, K1A 0K9, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, K1H 8M5, Canada.
²⁴ Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FI40014, Finland; Centre for Active Living and Learning, University of Newcastle, Newcastle, NSW, 2308, Australia.
²⁵ Healthy Activity Living and Obesity (HALO) research group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1, Canada; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA, 5001, Australia; Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, K1A 0K9, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, K1H 8M5, Canada. Electronic address: justin.lang@phac-aspc.gc.ca.
²⁶ Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada; and CIBEROBN Physiopathology of Obesity and Nutrition; Granada, ES18071, Spain.

PMID: 39577493
DOI: 10.1016/j.jshs.2024.101012

Abstract

Background: Physical fitness in childhood and adolescence is associated with a variety of health outcomes and is a powerful marker of current and future health. However, inconsistencies in tests and protocols limit international monitoring and surveillance. The objective of the study was to seek international consensus on a proposed, evidence-informed, Youth Fitness International Test (YFIT) battery and protocols for health monitoring and surveillance in children and adolescents aged 6-18 years.

Methods: We conducted an international modified Delphi study to evaluate the level of agreement with a proposed, evidence-based, international fitness battery (YFIT) of core health-related fitness tests and protocols to be used worldwide in 6- to 18-year-olds. This proposal was based on previous European and North American projects that systematically reviewed the existing evidence to identify the most valid, reliable, health-related, safe, and feasible fitness tests to be used in children and adolescents aged 6-18 years. We designed a single-panel modified Delphi study and invited 216 experts from all around the world to answer this Delphi survey, of whom one-third are from low-to-middle income countries and one-third are women. Four experts were involved in the piloting of the survey and did not participate in the main Delphi study to avoid bias. We pre-defined an agreement of ≥80% among the expert participants to achieve consensus.

Results: We obtained a high response rate (78%) with a total of 169 fitness experts from 50 countries and territories, including 63 women and 61 experts from low- or middle-income countries/territories. Consensus (>85% agreement) was achieved for all proposed tests and protocols, supporting the YFIT battery, which includes weight and height (to compute body mass index as a proxy of body size/composition), the 20-m shuttle run (cardiorespiratory fitness), handgrip strength, and standing long jump (muscular fitness).

Conclusion: This study contributes to standardizing fitness tests and protocols used for research, monitoring, and surveillance across the world, which will allow for future data pooling and the development of international and regional sex- and age-specific reference values, health-related cut-points, and a global picture of fitness among children and adolescents.

Keywords: Delphi; Experts; Fitness; Protocols; Youth Fitness International Test.